Your browser is no longer supported

For the best possible experience using our website we recommend you upgrade to a newer version or another browser.

Your browser appears to have cookies disabled. For the best experience of this website, please enable cookies in your browser

We'll assume we have your consent to use cookies, for example so you won't need to log in each time you visit our site.
Learn more

Critical care

  • Comment
Critical care services are an essential part of hospital services and patients who require critical care are among the sickest in the hospital, needing extensive facilities and equipment as well as dedicated and highly skilled multidisciplinary teams.

This kind of care is classified into three levels (by the Intensive Care Society):
- Level 1: Patients at risk of their condition deteriorating,or those recently relocated from higher levels of care whose needs can be met on an acute ward with additional advice and support from the critical care team
- Level 2: Patients requiring more detailed observation or intervention including support for a single failing organ system or postoperative care, and those stepping down from higher levels of care
- Level 3: Patients needing monitoring and support for two or more organ systems one of which may be basic or advanced respiratory support.

Nurses working in critical care have specific skills, knowledge and competencies to look after critically ill patients and part of that role is continuous observation of patients. Close monitoring and observations can reduce a patient's risk of deterioration and further complications.

The Department of Health believes that current arrangements to identify all the hospital patients that require critical care, especially those in general wards, are inadequate. It has been trying to modernise critical care services since 2000 and increase capacity.

Its Adult Critical Care Stakeholder Forum was established in 2004 to mobilise all interested parties in improving critical care services and to provide a communications link between various professional, operational and managerial groups delivering critical care.

The Stakeholder Forum says critical care needs to be viewed as a whole system, including dedicated critical care units, but also resources to support at-risk patients on general wards, and services supporting rehabilitation of patients recovering from critical illness in the hospital and in primary care.

The ideal effective critical care service, it believes, should include 24/7 outreach services, provision for comprehensive rehabilitation, good transfer and transport arrangements, and 24/7 support services.

Such a good service is reliant on an appropriately skilled workforce, so there is a need to review the numbers and skills of staff caring for critically ill patients in all settings. The issue of appropriate nurse staffing levels for intensive care units has been debated in the past few years, although everyone seems to agree that adequate training must be provided, roles redesigned and new roles developed.

The need for critical care outreach services has been known for some time and is a way of improving patient outcomes by identifying signs that a patient is deteriorating and acting on it before that patient has to be admitted to a critical care area.

Updated: September 2006

  • Comment

Have your say

You must sign in to make a comment

Please remember that the submission of any material is governed by our Terms and Conditions and by submitting material you confirm your agreement to these Terms and Conditions. Links may be included in your comments but HTML is not permitted.